Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | POD001018 | GA |
Y | 222Z00000X | Podiatrist | POD001018 | GA |
N | 213EP1101X | Primary Podiatric Medicine | 003766 | OH |
NPI | 1073589412 |
---|---|
Provider Name | Dr. Kimberly Harris Lewis |
First Address | Cincinnati, OH 45240-4004 |
Second Address | Cincinnati, OH 45240-4004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2006 |
Last Update Date | 17/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
131408692A | (05) | GA |
U91325 | (02) |